On 6/14/2011 11:43 AM, Jeff M wrote:
On 6/14/2011 1:25 PM, RD Sandman wrote:
[snip]
Poll: 58 percent want Medicare kept as is.

And, probably 58% of those have no idea how Medicare is paid for.

However, Medicare significantly outperforms private insurance in
controlling the rising cost of health care.

http://www.consumerwatchdog.org/node/11672

Sometimes it takes just a couple of numbers to clarify a huge, complex
issue--In this case, what to do about Medicare. Medicare costs are up
400% since 1969--scary, right? But private health insurance premiums in
the same period are up 700%--nearly twice as scary.

In today's New York Times, economist and columnist Paul Krugman uses
these figures to take on a seemingly moderate attempt to reform
Medicare, after a plan to do away with direct funding of Medicare (the
GOP budget plan) died in the Senate. The new plan, from Sen. Joe
Lieberman, is to raise the age of eligibility for Medicare from 65 to
67. The plan would toss 65- and 66-year-olds back to the private market
to buy health insurance on their own--in the name of "saving" Medicare.
But just like the GOP plan to privatize all Medicare, Lieberman's idea
fails from the start.

Krugman acknowledges that Medicare is a huge and rising cost--up 400%,
adjusted for inflation, since its inception in 1969. But what about
private insurance? Up 700%:

So while it’s true that Medicare has done an inadequate job of
controlling costs, the private sector has done much worse. And if we
deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get
private insurance — if they can — that will cost much more than it would
have cost to provide the same coverage through Medicare.

By the way, we have direct evidence about the higher costs of private
insurance via the Medicare Advantage program, which allows Medicare
beneficiaries to get their coverage through the private sector. This was
supposed to save money; in fact, the program costs taxpayers
substantially more per beneficiary than traditional Medicare.

Krugman cites all the familiar figures from the rest of the developed
world, where some mix of public insurance with some private elements
manages to cover almost everyone and at a much lower cost than in the
United States. But that less-private system of health care been taken
off the table in this country by the private corporate interests who
profit from the expensive mess of a health care system we have now.

But further privatizing health care, especially for the elderly, is very
far in the wrong direction--even the seemingly moderate proposal by
Lieberman to up the Medicare age to 67. From Krugman:

Not every 65- or 66-year-old denied Medicare would be able to get
private coverage — in fact, many would find themselves uninsured. So
what would these seniors do?

Well, as the health economists Austin Frakt and Aaron Carroll document,
right now Americans in their early 60s without health insurance
routinely delay needed care, only to become very expensive Medicare
recipients once they reach 65. This pattern would be even stronger and
more destructive if Medicare eligibility were delayed. As a result, Mr.
Frakt and Mr. Carroll suggest, Medicare spending might actually go up,
not down, under Mr. Lieberman’s proposal.

These are crazy times in government, when leading politicians see a
for-profit industry as the way to cut Medicare spending. Especially when
the for-profit industry is driving spending much faster than the
government alternative.

And for those who say it's not just about money, that the private market
does a better job overall--guess what? Medicare is better on all counts,
according to a major 2002 study by the Commonwealth Fund. The study's
bottom line: "Medicare outperforms private sector plans in terms of
patients' satisfaction with quality of care, access to care, and overall
insurance ratings."

So yes, Medicare needs better cost controls, but it's already
cheaper--and better--than private insurance would be for Americans who
are 65-plus. The real conundrum is how to get the same better deal for
the rest of us.


The answer to that question is well known. The way to get full coverage
for everyone and at the lowest cost is with a national single-payer
system. Other countries have already taken this route and provide
everyone health care at about half what we pay. Their people outlive us
too.

Our problem is that we have so many free market fundamentalist freaks
who refuse to have any system except one where the market rules. All the
evidence shows that no free market system can provide everyone health
care as good and as cheaply as a single payer government run system can.
Those people are what is keeping us from getting a modern health care
system because they won't allow anything but a market system. Even when
the facts show they don't work.

So to get a good health care system the free market freaks have to be
overcome. And they will be. It's only a matter of time. Twenty years
from now we'll have one of if not the best national health care system
in the world. People will look back and wonder why it took us to adopt a
system that is obviously the best one out there. But all of us will know
it was because of how hard it was to overcome the free market freaks.

Hawke